Volume 193 - Issue 1
In Other Journals
Author: Alison Williams
Med J Aust 2010; 193 (1): 58. || doi: 10.5694/j.1326-5377.2010.tb03746.x
Published online: 5 July 2010
Published online: 5 July 2010
Vision and falls
For older people with presbyopia, changing glasses for different activities can prevent falls. Although multifocal glasses are helpful for activities that require changes in focal length, they impair depth perception and have been shown to increase the risk of tripping and falling. Sydney researchers performed a randomised trial over 13 months among elderly regular wearers of multifocal glasses, in which the intervention group swapped to using single lens distance glasses for activities outside their own home such as walking, going up and down stairs and covering uneven ground. They found only a modest 8% reduction in falls in the intervention group overall, but a much larger (40%) reduction in a subgroup who usually engaged in regular outdoor activities. However, for those who did not normally take part in outdoor activities, the change in glasses significantly increased their risk of an outdoor fall. The authors of a linked editorial cautioned that any changes to glasses in the elderly involve careful instruction, and should be introduced gradually so that the person is not overwhelmed.
BMJ 2010; 340: c2265. doi:10.1136/bmj.c2265BMJ 2010; 340: c2456 .doi:10.1136/bmj.c2456
Flu and flying
In 2009, nine members of a school group travelling in the rear section of a Boeing 747 had flu-like symptoms during the long-haul flight, and pandemic (H1N1) 2009 influenza infection was confirmed on reaching their destination. What was the risk of spreading infection to other passengers? At 3.5% for passengers within two rows of the school group and 1.9% for the passengers in the entire rear section of the plane, the risk was lower than expected, according to an investigation by public health officials. The spread of infection was confined to those seated within two rows of the infected school group. Rigorous follow-up of those seated in the rear of the aircraft located 93% of passengers, but found that only three passengers subsequently developed confirmed infection within 3 days of exposure. The low transmissibility of H1N1 influenza suggests that focusing on passengers seated near infected passengers may be a more appropriate use of resources than following up all passengers on a flight.
BMJ 2010; 340: c2424. doi:10.1136/bmj:c2424
Benefits of happiness
Having a positive affect — experiencing pleasurable emotions such as joy, enthusiasm, contentment and excitement — may prevent coronary heart disease (CHD), says a report from the Canadian Nova Scotia Health Survey. The researchers claim this is the first prospective study to show an independent relationship between positive affect and coronary heart disease. The study assessed the positive affect of 1739 healthy adults on a five-point scale ranging from “none” to “extreme”. Positive affect was associated with a hazard ratio for CHD of 0.78 (95% CI, 0.63-0.96; P = 0.02) per point on the scale, after controlling for other cardiovascular risk factors. The researchers suggest that physiological mechanisms, such as reduced heart rate and sympathetic activity, may confer protection from heart disease, although a direct cause and effect relationship is yet to be proven.
Eur Heart J 2010; 31: 1065-1070 doi:10.1093/eurheartj/ehp603
Breastfeeding and fever
Fever is one of the most common adverse effects after infant immunisations — can it be reduced by breastfeeding? Mothers attending an immunisation clinic in Naples, Italy, were asked to record their baby’s temperature for 3 days after the infant received a routine hexavalent combination vaccine. Of 460 infants, fever (≥38°C) was reported in 25% of exclusively breastfed infants, 31% of those partially breastfed and 53% of infants who were not breastfed at all. The relative risk for fever among exclusively and partially breastfed infants was 0.46 (95% CI, 0.33–0.66) and 0.58 (95% CI, 0.44–0.77), respectively, and the protective effect remained even after adjustment for potential confounders. Different immune responses in breastfed infants and the presence of anti-inflammatory agents in breastmilk may explain this observation, according to the authors.
Pediatrics 2010; 17 May. doi:10.1542/peds.2009-1911
Neighbourhood design and obesity
Choice of neighbourhood can help adolescents avoid obesity, with opportunities for physical activity such as sport and provision of safe walking and cycling paths to and from community venues playing an important role. In a large national cross-sectional study conducted in the US, researchers correlated the prevalence of obesity among 13–16-year-olds with their physical activity, type of sports venues available and their perceived personal safety within the neighbourhood. Perception of safety was the strongest predictor of physical activity. Interestingly, there was no association between the presence of parks and sports fields and increased physical activity; the authors suggest that park users are primarily children and adults, and these settings may be less important for older youths. Such information should guide future developments to create more active neighbourhoods.
J Adolesc Health 2010 doi:10.1016 j.jadohealth.2010.03.017